In-Hospital Falls Often Linked to Nocturnal Toileting

In a study, 28% of all incident in-hospital falls were associated with nighttime visits to the toilet.

PHILADELPHIA—More than one quarter of all reported in-hospital falls is associated with nocturnal toileting, study findings reported at the International Continence Society’s 2018 annual meeting suggest.

In a single-center retrospective pilot study conducted at a tertiary referral hospital, 125 (28%) of 447 reported incident in-hospital falls from January 1, 2015 to December 31, 2015 were associated with nocturnal toileting, according to investigator Ronny Pieters, RN, of Ghent University Hospital in Ghent, Belgium, who presented study findings. Thirty-nine falls were associated with daytime toileting.

The hospital services with the most reported incident falls were geriatrics (74 falls), rehabilitation (55), gastroenterology (34), hematology (30), and neurology (30). Of the 447 falls, 242 (54%) occurred from 8:00 p.m. to 7:59 a.m. The most reported mechanisms of fall were loss of balance (26%) and slipping (25%). Most patients (58%) suffered no injuries from their falls.

According to Dr Pieters’ group, the proportion of falls associated with nocturnal toileting in 2015 (28%) is probably an underestimate. They noted, for example, that approximately 20% to 25% of incident falls are not reported in incident reports.

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Dr Pieters and his colleagues observed that urine production in healthy individuals is lower at nighttime compared with daytime. Consequently, it would be expected that the prevalence of incident falls associated with going to the toilet to be lower at nighttime than daytime. Their study showed, however, that the majority of falls associated with toileting happened at nighttime (76% vs 24%).